Quote of the Month
Alone we can do so little; together we can do so much. – Helen Keller
On July 16, the sixth White House Conference on Aging (WHCOA) was held at the White House. Bruce Chernof, president and CEO of The SCAN Foundation, authored a summary about the event, Not Your Parents’ White House Conference on Aging. Videos of the event are now posted online. There were numerous announcements made at the event such as those related to elder justice, nursing home regulations, falls prevention, transportation, and retirement security.
Among the initiatives related to elder justice, the Department of Justice plans to train elder abuse prosecutors in all 50 states to effectively prosecute elder abuse and financial exploitation and develop online training for law enforcement officers. The Department of Justice also plans to issue a final rule that “will revise the current Victims of Crime Act Victim Assistance guidelines by clarifying that VOCA assistance funds may be used to support legal services for crime victims, and emphasize the need to use VOCA funds to support social and legal services to underserved victims, including elder victims of abuse, financial exploitation, fraud and neglect.” (It’s important to note that Congress recently lifted the cap on spending under VOCA from $700 million to $2.3 billion.) The Department of Justice’s National Institute of Justice and its Elder Justice Initiative will fund a multiyear pilot project to evaluate potential ways to avoid and respond to elder mistreatment.
The Centers for Medicare and Medicaid Services (CMS) published its proposed revisions to the current regulations (also known as the Requirements of Participation) for nursing homes participating in Medicare and/or Medicaid. Read the full text of the proposed regulations here. This is the first proposed change in about 30 years. Formal comments are being accepted until September 14th, 2015 through the Federal Register site. While the proposed regulations make some improvements, advocates are disappointed that CMS did not address understaffing in the proposal. It does not establish a minimum staffing standard or a requirement for the twenty-four hour presence of a registered nurse in facilities. Click here to read more from the Center for Medicare Advocacy.
Aging in Place Technology Watch has a blog post about 5 technology related announcements from the 2015 WHCOA including information about the following: the American Bankers Association Foundation’s new Banks in their Communities interactive map; ACL’s new website Aging.gov;JoinHonor that will be offering $1 million in free home care in 10 cities; Philips’ new AgingWell Hub; and, the expansion of UberAssist.
Congress Passes NOTICE Act (Observation Status)
Last week, the U.S. Senate unanimously approved legislation passed in the House requiring hospitals to notify Medicare patients when they receive “observation care” but have not been admitted to the hospital. Observation status has been an issue impacting Medicare beneficiaries in traditional Medicare (Parts A and B) for many years. The Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act requires hospitals to give written notification to Medicare beneficiaries 24 hours after receiving observation care, stating that they have not been admitted to the hospital, the reasons why, and the potential financial implications. These beneficiaries must spend three consecutive nights as an “admitted” patient in a hospital to qualify for Medicare’s nursing home coverage. Time spent in observation isn’t counted. (PA passed a similar law requiring notification of observation status.) The number of hospital claims for observation care continues to rise. According to CMS, total claims increased 91% since 2006, to 1.9 million in 2013. Observation stays lasting 48 hours or more increased by 450% to 170,219 during the same period, according to Kaiser Health News.
The NOTICE Act will not solve the out-of-pocket costs and problems consumers experience as a result of observation status but it does change CMS’ ridiculous current policy of leaving it up to beneficiaries to ask if they are under observation status or if they have been admitted.
On June 1st, the Pennsylvania Department of Human Services (DHS) made a major announcement about a new initiative to pursue Managed Long-Term Services and Supports (MLTSS) in Pennsylvania. DHS issued a discussion document which provides an outline of the components DHS wants to include in its MLTSS system. Please see the first article in the June edition of CARIE Connection for more information about the proposal as well as information about the Centers for Medicare and Medicaid Services (CMS) proposed rule to modernize regulations concerning Medicaid managed care. The comment period for the discussion document is now closed but DHS stated its intentions to release a “requirements document” in late August that will have more details about the MLTSS plan. It is expected that the new document will open a new comment period.
Pennsylvania state agency officials (including Ted Dallas the Secretary of DHS, Teresa Osborne, the Secretary of the PA Department of Aging (PDA), and Jennifer Burnett, the Deputy Secretary for Long Term Living) held six “Public Input Sessions” that concluded on June 26 in Philadelphia. About 200 people attended each meeting and interested stakeholders were given 3-5 minutes to provide verbal comments. Some common themes presented included concerns about the quick timeline and desire for more time for stakeholder input to the planning process before a RFP is released. Diane Menio presented testimony at a public input meeting held in Philadelphia and submitted more detailed written comments on July 14.
- Creating an advisory committee with at least 50 percent representation by participants and caregivers and conducting monthly webinars
- Doubling the number of staff who work on Nursing Home Transition (NHT)
- Restructuring existing contracts to provide more choice for participants (DHS is planning to reprocure contracts for the financial management service provider, currently PPL, and independent enrollment broker, currently Maximus for under 60 Waivers and the AAAs for the Aging Waiver, as well as establish a new way to deliver home modification services.)
Jennifer Burnett announced DHS plans to hold monthly webinars on the third Thursday each month, although nothing has been formally posted on DHS’ website as of this writing.
In follow-up to the newly announced advisory committee, DHS is accepting nominations from those interested in serving on this advisory group. “The purpose of the Managed Long-Term Services and Supports (MLTSS) Subcommittee will be to review materials and advise the MAAC and the Department on policy development, program administration and new and innovative approaches to long-term services as the Commonwealth rolls out the new MLTSS delivery model.” Here is the form and instructions to be used for nominations, which are due by close of business Friday, August 7, 2015. The form is available in alternate format upon request by calling 717-783-8412.
CARIE held its first webinar, Pennsylvania’s MLTSS Proposal: Key Considerations for Advocates, on June 30, 2015. Click here for all of the webinar slides. (Unfortunately, we had some technical difficulties. The webinar recording started a bit late and it took a few minutes to mute the background noise.) CARIE’s webinar featured Eric Carlson, Directing Attorney for Justice in Aging, who discussed key MLTSS issues of importance to consumers and provided guidance to PA advocates to help in preparing comments by the July 15th deadline. Eric reviewed Justice in Aging’s MLTSS toolkit and Advocate’s Library of Managed Long-Term Services and Supports Contract Provisions, “resources that can help advocates ensure that states and plans get the details right.”
Pennsylvania started its new fiscal year on July 1 but the budgetremains at a stalemate. House Bill 1192 was sent to Governor Wolf but he vetoed the entire budget. Here is FAQs including a list of what the state will continue to reimburse during the budget impasse. On June 25, 2015, CARIE sent these Budget Recommendations to key members of the Pennsylvania legislature as part of an advocacy effort to help ensure the needs of older Pennsylvanians are addressed in the final budget for this FY. Advocates are encouraged to continue to advocate for the budget needs of older adults with members of the General Assembly and the Governor.
Webinars and Videos
The New Jersey Geriatric Education Center is presenting a free, 5-module, web-based program on dementia care running from Aug. 5 to Sept. 30. The modules cover the inter-professional approach to assessment and management of Alzheimer’s disease and dementia. The series is provided with funding from the Health Resources and Services Administration and in collaboration with ACL. Registration is required and some continuing education hours are available.
“With humor and candor, BEFORE YOU KNOW IT celebrates the bold and brave lives of active gay senior citizens who have witnessed unbelievable change in their lifetimes: from the Stonewall Riots and gay liberation to the HIV/AIDS pandemic and gay marriage rights.”
Just the Links
ACL and its grantees shared new resources on the topics of promoting brain health and coping with the symptoms of dementia including:Dementia-capable States and Communities: the Basics is an issue brief which defines dementia-capability and explores how to create “dementia-capable” long-term services and supports at the state and local levels; Dementia-capability quality assurance assessment tools have been developed for both states and community-based entities; and Responding to the Wandering Behavior of People with Dementia describes the needs of people with dementia who wander and discusses how to use person-centered approaches to address the challenges of wandering.
HHS posted its National Plan to Address Alzheimer’s Disease: 2015 Update.
AARP Public Policy Institute (PPI) & National Alliance for Caregiving released a report, Caregiving in the U.S. 2015 and AARP PPI also released, Valuing the Invaluable 2015 Update: Undeniable Progress, but Big Gaps Remain.
Also from AARP and Feeding America a report, Baby Boomers and Beyond: Facing Hunger After Fifty
The Assistance Secretary for Planning and Evaluation (ASPE) posted a new report on Long-Term Services and Supports (LTSS).
A new Alliance for Health Reform toolkit, Long-Term Services and Supports: Changes and Challenges in Financing and Delivery, explains the current LTSS system, trends in the delivery of care and the current policy challenges.
“In the United States, one out of every five adults has a disability, according to a new study published by the Centers for Disease Control and Prevention. The most common functional disability type was a mobility limitation – defined as serious difficulty walking or climbing stairs — reported by one in eight adults, followed by disability in thinking and/or memory, independent living, vision, and self-care.” Here’s an infograph from the study.
Justice in Aging has updated their guide, 20 Common Nursing Home Problems and How to Resolve Them, and they are making it available for free download.
The National Association for Home Care & Hospice (NAHC) released awhite paper on palliative care, designed to be a comprehensive resource that addresses everything an organization needs to consider related to palliative care.
The National Center on Senior Transportation released a new brochure and tip sheet, Falls Prevention Awareness in Public Transportation Brochure and Printable Tip Sheets for Drivers and Older Rider.
ACL Online Learning Tool: Building Respect for LGBT Older Adults has been posted by the National Resource Center on LGBT Aging.
Disability.gov has developed a series of 14 guides about topics such as disability benefits, housing assistance, home health care, programs for caregivers, assistive technology, and more.
Social Security has a new resource to help connecting the homeless to needed benefits.
State Dept. of Health needs to strengthen oversight of Pa.’s nursing homes is a story on Lancaster online related to CLS’ new report,Careless: How the Pennsylvania Department of Health Has Risked the Lives of Elderly and Disabled Nursing Home Residents
PA’s Legislative Budget and Finance Committee released a report, The Commonwealth’s Network of Elder Abuse Task Forces.
Just for Fun
Did you know that Philadelphia has the largest operating pipe organ in the world?
CARIE posted a blog – How Do Federal Agencies Respond to Complaints of Medicare Fraud and Abuse.
Golden Games is scheduled for September 16, 2015 at Carousel House. Golden Games, originally known as Philadelphia Senior Olympics, started with four nursing homes participating. Today up to 15 nursing homes and LIFE programs (for those who live at home but are nursing home eligible) from all over Philadelphia assist in planning, attending and participating in the event. Please contact Lori Walsh if you are interested in volunteering at this year’s event.
CARIE Connection Archives
Are looking for a past issue of CARIE Connection? Click here to access past newsletters.
Public Policy Meeting Announcement
The next Dorothy S. Washburn Legislative Committee meeting will be held from 9:30 to 11:30 on Thursday, August 6, 2015 at CARIE’s office at Two Penn Center – Suite 1500. Here is the agenda. All are welcome. Hope you can join us. The following meeting is tentatively scheduled for September 3.
As always, please contact me if you have any questions.
267-546-3438 or 1-800-356-3606, ext. 3438